Incidental Finding of Coronary and Non-Coronary Artery Calcium: What Do Clinicians Need To Know?

Purpose Of Review: This review summarizes the role of incidentally and non-incidentally discovered coronary artery calcification (CAC) and the evolving role of non-coronary artery calcification in atherosclerotic cardiovascular disease (ASCVD) risk assessment. Additionally, this review explores the emerging use of artificial intelligence (AI), machine learning (ML), radiomics, and natural language processing (NLP) for automated detection, quantification, and communication of these incidentally discovered findings.

Recent Findings: This review summarizes recent findings in the space, including the development of various AI/ML-based approaches for automated calcification quantification and detection.

Artificial Intelligence in Ischemic Heart Disease Prevention.

Purpose Of Review: This review discusses the transformative potential of artificial intelligence (AI) in ischemic heart disease (IHD) prevention. It explores advancements of AI in predictive modeling, biomarker discovery, and cardiovascular imaging. Finally, considerations for clinical integration of AI into preventive cardiology workflows are reviewed.

Milvexian: An Oral, Bioavailable Factor XIa Inhibitor.

Direct oral anticoagulants have a dose-dependent increased bleeding risk which limits use in certain populations. Studies in both animals and humans with inherited variations in factor XI levels provide a theoretical basis for a drug target capable of addressing current unmet needs. Milvexian is an oral factor XIa inhibitor that has the potential to provide robust anticoagulant effect without increased bleeding compared with current standard of care.

Measurement and Application of Incidentally Detected Coronary Calcium: JACC Review Topic of the Week.

Coronary artery calcium (CAC) scoring is a powerful tool for atherosclerotic cardiovascular disease risk stratification. The nongated, noncontrast chest computed tomography scan (NCCT) has emerged as a source of CAC characterization with tremendous potential due to the high volume of NCCT scans. Application of incidental CAC characterization from NCCT has raised questions around score accuracy, standardization of methodology including the possibility of deep learning to automate the process, and the risk stratification potential of an NCCT-derived score.

Risk-adjusted analysis of perioperative outcomes after the Sistrunk procedure.

Objectives: Thyroglossal duct cyst (TGDC) is the most common pediatric congenital neck mass. The Sistrunk procedure is the standard method of excision and is associated with low rates of recurrence. This study aimed to review our institution's outcomes following the Sistrunk procedure, specifically the rates of wound complications and cyst recurrence.

Frailty Status Modifies the Efficacy of ICD Therapy for Primary Prevention Among Patients With HF.

Background: Implantable cardioverter-defibrillator (ICD) therapy is recommended to reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF). Frailty is common among patients with HFrEF and is associated with increased mortality risk. Whether the therapeutic efficacy of ICD is consistent among frail and nonfrail patients with HFrEF remains unclear.

The Role of Fecal Microbiota Transplantation in the Induction of Remission in Ulcerative Colitis.

Background: Considerable research supports an important role for the microbiome and/or microbiome-host immune system interactions in the pathogenesis of inflammatory bowel disease (IBD). Consequently, microbiota-modulating interventions, such as fecal microbiota transplantation (FMT), have attracted interest in the management of IBD, including ulcerative colitis (UC).

Summary: While the clinical response to FMT in UC has varied between different studies, results to date may offer guidance toward optimal use of FMT.

Scattering angle resolved optical coherence tomography measures morphological changes in colonies.

Significance: An unmet need is recognized for early detection and diagnosis of neurological diseases. Many psychological markers emerge years after disease onset. Mitochondrial dysfunction and corresponding neurodegeneration occur before onset of large-scale cell and tissue pathology.

Use of Optical Coherence Tomography (OCT) in Assessment of Diabetic Skin Wound Characteristics and Blood Flow.

Optical coherence tomography allows for various measurements of skin but the utility of the device in determining properties of normal and wounded skin in diabetic patients is unknown. This single-site, non-randomized, observational study used an optical coherence tomography device to acquire skin images at 1305 nm, creating real-time image of 17 patient's skin and wounds 1 to 2 mm under the skin surface. Vertical B-scan, en-face and 3-D images were produced to calculate surface and dermal-epidermal junction roughness, the optical attenuation coefficient, a measure of light absorption and scattering, and blood flow metrics.

Evaluation and characterization of facial skin aging using optical coherence tomography.

Objectives: The skin aging exposome encompasses internal and external factors that contribute to clinical signs of facial aging. Aging skin can be characterized by distinctive features such as wrinkles, lentigines, elastosis, and roughness. Optical coherence tomography (OCT) is capable of noninvasively measuring skin characteristics.

Pediatric Tissue Expansion: Analysis of the National Surgical Quality Improvement Program-Pediatric.

Introduction: Tissue expansion (TE) in pediatric surgery provides vascularized tissue to attain functional and esthetic goals in a broad range of reconstructive procedures. Our study evaluates the demographic, operative, and short-term outcomes of TE in pediatric patients utilizing the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database and highlights factors associated with postoperative complications.

Materials And Methods: Retrospective review of a large multicenter database of 402 pediatric patients that underwent TE within the NSQIP-P database from 2013 to 2020 at freestanding general acute care children's hospitals, children's hospitals within a larger hospital, specialty children's hospitals, or general acute care hospitals with a pediatric wing.

The Efficacy of Intense Pulsed Light as a Treatment for Benign Pigmented Lesions on the Dorsal Hand.

Background: Intense pulsed light (IPL) is a noninvasive therapeutic option to treat benign pigmented lesions by targeting melanin.

Objective: The purpose of this study was to assess IPL as a treatment for benign pigmented dorsal hand lesions.

Materials And Methods: A total of fifteen subjects, 40 to 73 years old, received 3 monthly IPL treatments over the dorsal hands.

Temporal and Spatial Assessment of the Corneal Response to UV Cross-Linking Using 3-Dimensional In Vivo Confocal Microscopy.

The goal of this study was to evaluate the temporal and spatial pattern of wound healing following UV corneal cross-linking (CXL) using 3-dimensional (3-D) confocal imaging in vivo. Using a modified Heidelberg Retinal Tomograph with Rostock Corneal Module confocal microscope, we performed 3-D scans on two patients at multiple time points after CXL. Patient 1 showed a normal post-CXL wound healing response, with initial subbasal nerve loss and keratocyte apoptosis in the anterior stroma, followed by partial restoration of both the nerve plexus and stromal keratocytes by 6 months.

Open Versus Minimally Invasive Approach for Craniosynostosis: Analysis of the National Surgical Quality Improvement Program-Pediatric.

Objective: This multicenter study aimed to compare demographic, operative, and short-term outcomes data between open and minimally invasive surgical approaches for craniosynostosis repair utilizing the American College of Surgeon's National Surgical Quality Improvement Program Pediatric (NSQIP-P) database and highlight surgical disparities among races and ethnicities.

Design: Retrospective review of large multicenter database.

Setting: Freestanding general acute care children's hospitals, children's hospitals within a larger hospital, specialty children's hospitals, or general acute care hospitals with a pediatric wing.

Current and Future Photography Techniques in Aesthetic Surgery.

Background: The rapidly increasing modalities and mediums of clinical photography, use of 3-dimensional (3D) and 4-dimensional (4D) patient modeling, and widening implementation of cloud-based storage and artificial intelligence (AI) call for an overview of various methods currently in use as well as future considerations in the field.

Objectives: Through a close look at the methods used in aesthetic surgery photography, clinicians will be able to select the modality best suited to their practice and goals.

Methods: Review and discussion of current data pertaining to: 2-dimensional (2D) and 3D clinical photography, current photography software, augmented reality reconstruction, AI photography, and cloud-based storage.

Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy.

Background: Noninvasive treatments for skin tightening are gaining popularity. However, no studies have assessed bipolar fractional radiofrequency treatment on suprapatellar skin.

Objectives: The purpose of this study was to evaluate the efficacy of bipolar fractional radiofrequency treatment on suprapatellar skin.